Croup (Laryngotracheitis)

Epidemiology

Croup is a viral upper respiratory tract infection most often due to parainfluenzae 1 and 2 and influenza A. It is most common in children between the ages of 1 and 3. This disease frequently occurs in winter and is more common in males.

Clinical Findings

Patients characteristically present with a characteristic barking cough and stridor. Croup usually lasts between 3 and 7 days. Croup may be called atypical if it lasts more than 7 days, occurs in infants < 1 year of age, or is unresponsive to antibiotics. Severe cases of croup may progress to complete laryngeal obstruction. The importance and severity of the disease is emphasized by the fact that stridor at rest does not occur unless > 80% of the lumen is narrowed. Thus a small amount of edema occurring in a compromised subglottis may lead to complete laryngeal obstruction.